A pragmatic perspective on mental disorders by psychiatrists of Karachi, Pakistan: A qualitative study

  • Rehana Khalil Department of Family & Community Medicine, Unaizah College of Medicine & Medical Sciences, Qassim University, Kingdom of Saudi Arabia https://orcid.org/0000-0001-6064-1537
  • Zahid Naeem Department of Community Medicine, Shifa College of Medicine, Shifa Tameer-e-Millat University, Islamabad, Pakistan
  • Allah Bachayo Rajar Department of Community Medicine, Muhammad Medical College, MirpurKhas, Pakistan
  • Uroosa Talib Karwan-e-Hayat Psychiatric Care & Rehabilitation Center, Karachi, Pakistan
Keywords: Pragmatic perspective, mental disorders in Pakistan, psychiatrist's perspective, qualitative study

Abstract

Introduction: There is an alarming rise in mental health problems in Pakistan, due to various reasons including genetic vulnerability. There is a paucity of reliable and updated data on mental illnesses in Pakistan.

Objective: The main objective of our study was to explore the perspective of psychiatrists on frequency of mental disorders, their related factors and expected recovery from mental illnesses in a Psychiatric Care and Rehabilitation center of Karachi, Pakistan.

Methodology: This qualitative study was conducted at the Karwan-e-Hayat Psychiatric Care and Rehabilitation center, Karachi, Pakistan from Dec 2019 to April 2020. Seventeen study participants were recruited through purposive sampling and data was collected through in-depth interviews. Qualitative thematic analysis of content was done though generation of a coding scheme.

Results: Analysis of the interview transcripts revealed two main themes related to psychiatrists’ views about mental disorders in Pakistan; (1) Contributing and consequential correlates of mental disorders (2) Effective therapeutic strategies and recovery rate from mental disorders.

Conclusion: Our study concluded that mental disorders are increasing with high proportion of psychosis and schizophrenia cases in Pakistan. The productive young age group and male gender are most commonly affected. The factors associated with mental disorders include lower socio-economic status, Low-literacy, divorce, exposure to traumatic events like violence and political turmoil, and sleep disturbances. The recovery rate from mental disorders is promising with integrative approach including pharmacological, psychosocial and care management strategies.

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References

Mackenzie, C. S., Gekoski, W. L., & Knox, V. J. Age, gender, and the underutilization of mental health services: The influence of help- seeking attitudes. Aging Ment Health. 2006; 10(6):574-82.

DOI: https://doi.org/10.1080/13607860600641200.

Birmaher B, Ryan ND, Williamson DE, Brent DA, Kaufman J, Dahl RE, et al. Childhood and Adolescent depression. A review of past 10 years. J Am Acad Child Adoles Psychiat. 1996; 35(11):1427-39.

DOI: https://doi.org/10.1097/00004583-199611000-00011.

World Health Organization. Depression Factsheet N* 369 (online) Oct 2014 (cited June 2015) Available from URL: http//www.who.int/media centre/ factsheet/fs369/en/

Ayesha Sarwat, Faryal Nawab, Nighat Nisar. Profile of Psychiatric Patients Attending Outpatient Clinic of a Tertiary Care Hospital, Karachi. Med. Forum, 2015; 26(7):31-34.

Gadit A, Vahidy A, Shafique F. Mental Health Morbidity: An experience in a community psychiatric clinic. J Coll Phys Surg Pak. 1998; 8(6):262-4.

Gadit AA, Vahidy A. Mental health morbidity pattern in Pakistan. J Coll Phys Surg Pak. 1999; 9:362-5.

Casey P A guide to psychiatry in primary care. 2nd Ed UK, Wnghtson Biomedical Publishing Company, 1993, pp.7.

Khan AG, Rahman R, Ansari M, Khan ZHAG, Hayder Z, Hussain M. Pattern Of Psychiatric Emergencies At Tertiary Care Hospital in Karachi. J. Pak. Psychiatr. Soc. 2010; 7(1):37-41.

DOI: https://doi.org/10.13140/2.1.1065.0249

Shahid M, Khan MZ, Ejaz K, Nakeer R, Iftikhar S. Profile of psychiatric patients presenting to a tertiary care emergency department of karachi. J Coll Phys Surg Pak. 2015; 25(5):386-88.

DOI: https://doi.org/05.2015/jcpsp.386388

Gadit AA. Psychiatry in Pakistan: 1947-2006: a new balance sheet. J Pak Med Assoc 2007; 57(9):453-63.

Safdar A. Sohail, Akhtar A. Syed and Atif Rahman. 2017. Mental health in Asia and the Pacific: Historical and Cultural Perspectives. Mental Health in Pakistan: Yesterday, Today and Tomorrow. Chapter 2. Springer. (pp.17-37). Available from URL: http://www.springer.com/978-1-4899-7997-1

Adler NE, Epel ES, Castellazzo G, Ickovics JR. Relationship of subjective and objective social status with psychological and physiological functioning: Preliminary data in healthy, White women. Health psychology. 2000; 19(6):586.

DOI: https://doi.org/10.1037/0278-6133.19.6.586

Collins AL, Goldman N. Perceived social position and health in older adults in Taiwan. Soc Sci Med. 2008; 66(3):536-44.

DOI: https://doi.org/10.1016/j.socscimed.2007.10.004

McLeod JD, Shanahan MJ. Poverty, parenting, and children's mental health. Am Soc Rev. 1993; 1:351-66.

DOI: https://doi.org/10.2307/2095905

Dohrenwend BP, Schwartz S. Socioeconomic status and psychiatric disorders. Curr Open Psychiatr 1995; 8(2):138-41.

DOI: https://doi.org/10.1126/science.1546291

Gove WR. The relationship between sex roles, marital status, and mental illness. Social forces. 1972; 51(1):34-44.

DOI: https://doi.org/10.1093/sf/51.1.34

Gove WR, Tudor JF. Adult sex roles and mental illness. Am J Soc. 1973; 78(4):812-35.

DOI: https://doi.org/10.1086/225404

Mumford DB, Minhas FA, Akhtar I, Akhter S, Mubbashar MH. Stress and psychiatric disorder in urban Rawalpindi: community survey. Brit J Psychiat. 2000; 177(6):557-62.

DOI: https://doi.org/10.1192/bjp.177.6.557

GADIT AA. Disaster, mental health and rescuing medical professionals. J Ayub Med Coll Abbottabad. 2005; 17(4).1-2.

Khalily MT, Fooley S, Hussain I, Bano M. Violence, psychological trauma and possible acute post-traumatic interventions in Pakistani society. Australas J disaster trauma stud. 2011; 1:1-9.

Tahir Khalily M. Developing an integrated approach to the mental health issues in Pakistan. J Interprof Care. 2011; 25(5):378-9.

DOI: https://doi.org/10.3109/13561820.2011.573598

Gadit AA, Vahidy A. Mental health morbidity pattern in Pakistan. J Coll Phys Surg Pak. 1999; 9:362-5.

DOI: https://doi.org/10.5334/ijic.662

Marzuk P. Violence, crime, and mental illness. How strong a link? Arch Gen Psychiatry.1996; 53(6):481-86.

DOI: https://doi.org/10.1001/archpsyc.1996.01830060021003

TV Channels of Pakistan. (Cited 4th July 2019). Available from URL: https://www.ranker.com/list/tv-channels-of-pakistan/tv-channels

Andrew D. Krystal. Psychiatric disorders and sleep. Neurol Clin. 2012; 30(4):1389-1413.

DOI: https://doi.org/10.1016/j.ncl.2012.08.018.

Investing in mental health. World Health Organization. 2003. (Accessed on 27th July 2019). Available from URL: https://apps.who.int/iris/bitstream/handle/10665/42823/9241562579.pdf

Patel V, Araya R, Chatterjee S, Chisholm D, Cohen A, De Silva M, et al. Treatment and prevention of mental disorders in low-income and middle-income countries. The lancet. 2007; 370(9591):991-1005.

DOI: https://doi.org/10.1016/S0140-6736(07)61240-9.

Liberman RP, Kopelowicz A. Recovery from schizophrenia: a challenge for the 21st century. Int Rev Psychiatry. 2002; 14(4):245-55.

DOI: https://doi.org/10.1080/0954026021000016897

Andresen R, Oades L, Caputi P. The experience of recovery from schizophrenia: towards an empirically validated stage model. Aust N Z J Psychiatry. 2003; 37(5):586-94.

DOI: https://doi.org/10.1046/j.1440-1614.2003.01234.x

Law H, Morrison AP. Recovery in psychosis: a Delphi study with experts by experience. Schizophr Bull. 2014; 40(6):1347-55.

DOI: https://doi.org/10.1093/schbul/sbu047

Morrison AP, Shryane N, Beck R, Heffernan S, Law H, McCusker M, et al. Psychosocial and neuropsychiatric predictors of subjective recovery from psychosis. Psychiat Res. 2013; 208(3):203-9.

DOI: https://doi.org/10.1016/j.psychres.2013.05.008

Lavin D, Ryan P. Using quantitative research to measure recovery outcomes and correlates. Ir J Psychol Med. 2012; 29(3):157-62.

DOI: https://doi.org/10.1017/S0790966700017183

Andresen R, Caputi P, Oades LG. Do clinical outcome measures assess consumer-defined recovery?. Psychiat Res. 2010; 177(3):309-17.

DOI: https://doi.org/10.1016/j.psychres.2010.02.013

Tse S, Davidson L, Chung KF, Ng KL, Yu CH. Differences and similarities between functional and personal recovery in an Asian population: a cluster analytic approach. Psychiatry: Interpersonal and Biological Processes. 2014; 77(1):41-56.

Published
2020-08-09
How to Cite
1.
Khalil R, Naeem Z, Rajar A, Talib U. A pragmatic perspective on mental disorders by psychiatrists of Karachi, Pakistan: A qualitative study. JSTMU [Internet]. 9Aug.2020 [cited 22Oct.2020];3(1):34 -1. Available from: https://j.stmu.edu.pk/ojs/index.php/jstmu/article/view/93